Overlawyered: Chronicling The High Cost Of Our Legal System

Posts Tagged ‘medical’

“Doctor says FEMA ordered him to stop treating hurricane victims”

By reader acclaim:

In the midst of administering chest compressions to a dying woman several days after Hurricane Katrina struck, Dr. Mark N. Perlmutter was ordered to stop by a federal official because he wasn’t registered with the Federal Emergency Management Agency. “I begged him to let me continue,” said Perlmutter, who left his home and practice as an orthopedic surgeon in Pennsylvania to come to Louisiana and volunteer to care for hurricane victims. “People were dying, and I was the only doctor on the tarmac (at the Louis Armstrong New Orleans International Airport) where scores of nonresponsive patients lay on stretchers. Two patients died in front of me.

“I showed him (the U.S. Coast Guard official in charge) my medical credentials. I had tried to get through to FEMA for 12 hours the day before and finally gave up. I asked him to let me stay until I was replaced by another doctor, but he refused. He said he was afraid of being sued. I informed him about the Good Samaritan laws and asked him if he was willing to let people die so the government wouldn’t be sued, but he would not back down. I had to leave.”

In a formal response to Perlmutter’s story, FEMA said it does not accept the services of volunteer physicians:

“We have a cadre of physicians of our own,” FEMA spokesman Kim Pease said Thursday. “They are the National Disaster Medical Team. … The voluntary doctor was not a credentialed FEMA physician and, thus, was subject to law enforcement rules in a disaster area.”

However, Perlmutter says once back in Baton Rouge his group

went to state health officials who finally got them certified — a simple process that took only a few seconds.

“I found numerous other doctors in Baton Rouge waiting to be assigned and others who were sent away, and there was no shortage of need,” he said.

(Laurie Smith Anderson, The Advocate (Baton Rouge), Sept. 16; Toby Harnden, “‘I could have saved her life but was denied permission'”, Daily Telegraph (UK), Sept. 18).

Read On…

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Louisiana protecting medical volunteers

Sydney Smith at MedPundit has a list of volunteer opportunities for medical professionals, and those in a position to donate medical supplies, in the hurricane aftermath. The text of Louisiana Gov. Kathleen Blanco’s executive order on out-of-state medical volunteers is here (PDF) and relevant excerpts appear on the Louisiana State Medical Society site. Briefly, Gov. Blanco’s order suspends licensure requirements for professionals licensed elsewhere and brings out-of-state medical personnel (but not, apparently, those who already practicing in Louisiana) under a liability umbrella by designating them as agents of the state for purposes of tort action provided they “possess[] current state medical licenses in good standing in their respective states of licensure and that they practice in good faith and within the reasonable scope of his or her skills, training or ability.” See Aug. 31, Sept. 2. More ways to help: NOLAHelp.com (via Ernie the Attorney).

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Caesarean sections in Australia

Use of the procedure seems to be following the American path, “and could soon hit a record of 32 per cent of deliveries — far higher than in countries such as Britain and New Zealand.” Among the factors:

Andrew Pesce, consultant obstetrician at Westmead Hospital in Sydney, told the conference litigation was a factor in the caesarean rates.

No obstetrician had ever been sued for doing a caesarean, while some of the largest medical negligence payouts — including the $11 million Calandre Simpson case in 2001- – followed claims the doctor should have performed a caesarean section earlier, Dr Pesce said.

(Adam Cresswell, “Midwives left ‘powerless’ by soaring caesar births”, The Australian, Sept. 5). See Nov. 29, 2004; Jul. 18 and Aug. 13, 2003; and Feb. 5, 2001.

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Doc probed for rude advice to obese woman, cont’d

“Doctors must be able to speak freely to their patients, even if it means hurting their feelings,” opines the Manchester Union-Leader. KevinMD has a link to that editorial, plus a roundup of blog reactions to the news item Ted covered in this space Aug. 25. More: Workers’ Comp Insider (Aug. 31) says the affair is more complicated, and the doctor’s conduct less sympathetic, than portrayed in early press reports. Even should that prove to be the case, the referral to the state AG’s office is at a minimum puzzling.

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Defensive medicine files

Who says there’s no defensive medicine? There’s always a fun discussion of such at the comments section of Kevin MD. One doctor:

I do that all the time. I tell my patients: “I don’t think you need a CT scan, but I’ll recommend it for liability purposes”.

Or “I don’t think you’re having a heart attack, but because of liability purposes, I recommend going to the ER”.

And another, who thinks the first isn’t being defensive enough to avoid litigation:

You’ve got to be careful how you word “I don’t think you’re having a heart attack”. On our AMA forms, it’s very specific: “You are at risk of death” if you don’t follow our recommendations. On the inside I know it’s alot of crap, that there’s nothing wrong with the patient, but I have only a million of coverage to back me up on this, so on the outside, I have to act like it’s a life or death situation they are admitted for their bogus chest pain.

Then a third chimes in to say that the second is fooling himself:

I’ve actually had a malpractice lawyer laugh and tell me how easily he can blow through an AMA form in court like it’s not even there, so even that doesn’t protect us against the sharks.

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“Doctor in trouble for calling patient obese”

By popular demand: the New Hampshire Board of Medicine is asking the attorney general’s office to investigate a complaint by a woman that Dr. Terry Bennett told her she was obese. Because the complaint is confidential, and news coverage has only told Bennett’s version of the story, there may be more to this tale than the seemingly absurd situation of possible government sanction for providing truthfully blunt and important health information to a patient suffering from a potentially life-threatening condition. But if the reporting is accurate, it would seem to be another piece of evidence that contradicts the frequent excuse of tort-reform opponents that aggressive medical malpractice lawsuits are needed to compensate for under-vigilant medical boards. (AP/MSNBC, Aug. 24).

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Litigation-driven surgery

Another cost of the litigation system not measured by the Tillinghast Towers Perrin study: pregnant women across the country are being required to undergo unnecessary C-sections so the doctors can avoid John-Edwards-style demagoguery in the event of pregnancy complications. C-sections now comprise 27.6% of pregnancies, and the cerebral palsy rate hasn’t declined at all.

Doctors and hospitals say they fear lawsuits if they allow a patient to attempt a vaginal birth after a C-section — called a VBAC — and something goes awry.

“We think the risk is more of a legal risk than a medical risk,” acknowledges Bob Wentz, CEO of California’s Oroville Hospital, which banned VBACs two years ago.

Thomas Frank asks what’s the matter with Kansas: it might be that a woman wanting to avoid a C-section has to travel 280 miles to find a hospital that will allow a VBAC. (Rita Rubin, “Battle lines drawn over C-sections”, USA Today, Aug. 23).

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Connecticut: a little favor for Koskoff, Koskoff and Bieder

The Bridgeport law firm of Koskoff, Koskoff and Bieder, which accounts for many of Connecticut’s high-profile settlements against doctors and other defendants, isn’t shy about throwing its political weight around in Hartford. Consider what happened after the firm got hit with a legal-malpractice suit from a former client, a widow who allegedly hadn’t been properly advised by attorney Rosalind Koskoff to file for workers’-comp benefits for her late husband, and was later ruled to have waited too long. As the widow’s malpractice suit against the law firm headed toward trial, two friends of the trial bar in the state senate, deputy majority leader Andrew McDonald and Sen. Edith Prague, tacked onto an unrelated bill an amendment which would have the state fork over the benefits the widow was suing for — not as a general rule, just in that one case — which would have the probable effect of knocking out the malpractice case by mootness. The bill became law, and the influential law firm can now presumably breathe a bit easier, glad it has cultivated so many friends in high political places. (Meir Rinde, “A Legislative Rat? The Koskoff Clause”, Hartford Advocate, Aug. 4).

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